Aussie oncologist reveals practise-changing results in lung cancer trial

Pharma News: A clinical trial spearheaded by an Australian medical oncologist has unveiled the efficacy of a novel treatment for lung cancer. The trial’s findings, which have the potential to redefine clinical practice, were published earlier this month.

Platinum-based chemotherapy has long been the standard adjuvant therapy for patients with resectable, ALK-positive non-small-cell lung cancer (NSCLC). However, the emergence of Roche’s targeted therapy, Alecensa (alectinib), is offering renewed hope for patients diagnosed with this aggressive form of lung cancer. The therapy is currently PBS listed for the treatment of patients with ALK positive, locally advanced or metastatic NSCLC.

Led by Professor Ben Solomon of Peter MacCallum Cancer Centre, the ALINA trial enrolled 257 patients diagnosed with early-stage ALK-positive NSCLC. This subtype of lung cancer, accounting for approximately 5% of all cases, is most prevalent among individuals who have never or rarely smoked.

According to the findings, patients treated with Alecensa experienced a substantial reduction in the risk of cancer recurrence following surgery compared to those who received traditional chemotherapy. Remarkably, 93.8% of patients in the Alecensa group remained alive and free of lung cancer two years post-treatment, contrasting with only 63.0% in the chemotherapy cohort. Even at the three-year mark, the disparity persisted, with 88.3% versus 53.3% remaining cancer-free, respectively.

“The great hope, in terms of improving outcomes for these patients, has been the arrival of a targeted drug that works well against this cancer and reduces the chance of the cancer returning after surgery” Professor Solomon remarked.

“In the ALINA trial, patients treated with alectinib after surgery had significantly improved disease-free survival compared to those who received conventional chemotherapy. Importantly, we also saw a benefit in terms of fewer brain metastases in patients whose lung cancer did return,” he further added.

The data revealed a striking difference in the incidence of cancer recurrence and brain metastases between the two treatment groups. Only 15 patients (11.5%) in the Alecensa group experienced cancer recurrence, in contrast to 49 (38.6%) in the chemotherapy cohort. Moreover, the incidence of brain metastases was notably lower among patients treated with Alecensa, with just 4 cases compared to 14 in the chemotherapy arm.

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